Mesh Selection in Abdominal Wall Reconstruction: An Update on Biomaterials

A wide array of mesh choices is available for abdominal wall reconstruction, making mesh selection confusing. Understanding mesh properties can make mesh choice simpler. Each mesh has characteristics that determine its durability, ability to clear an infection, and optimal position of placement in the abdominal wall. For clean retromuscular hernia repairs, we prefer bare, heavy weight, permanent synthetic mesh. For contaminated retromuscular abdominal wall reconstruction cases, such as parastomal hernia repairs, we typically use bare, medium weight, permanent synthetic mesh. Biologic and biosynthetic meshes also have acceptable wound event and hernia recurrence rates when used in contaminated cases.